Sunday, October 5, 2008

News Analysis: Understanding education funding

By William Doolittle
For the Messenger

Monroe County residents, because of their deep 
concern over soaring school populations and the
 resulting property tax increases, need to understand
 the broad context in which school funding occurs.


Peering back to the nation’s beginning, the Founding
 Fathers, in their wisdom, understood that in this
 large, new land one size would not fit all when it 
came to education.
 As a result the founders made no specific mention of 
national control, or funding, of education even though 
they understood education was absolutely necessary 
in a democracy that needs an educated electorate.


These men who were educated at home or in tiny schoolhouses down the lane left the running of schools to 
the states.
The Tenth Amendment of the Bill of Rights states,
“The powers not delegated to the United States by the
 Constitution, nor prohibited by it to the states, are
 reserved to the states respectively, or to the 
people.”


That is the only guidance given to the citizens of 
the United States about who is to run their schools. 
In a back-handed manner, the Tenth Amendment reserves the 
power and responsibility of public education systems 
exclusively to the states, by not enumerating that
 responsibility to the federal government.


But, you may exclaim, “My local school board runs the
 schools.” That is true, but only at the sufferance of 
the states, which have gingerly turned many function s
of school operations to local school boards. 
Hawaii runs a single statewide school system. To
 further prove the point that the states are, by law ,
in charge, there have been several instances in the 
past decade when the state took over entire school 
systems, among them Philadelphia, Newark and Jersey
 City.
Through the years, hard-pressed citizens have 
complained that several state methods of distributing
 so-called state aid to local districts is unfair 
because affluent districts are able to draw more money 
per student from property owners than poorer 
districts.

This is the downside of state control,
 because many legislatures are unable to, or unwilling 
to respond adequately to special situations such a s
fast growth.
 According to the state Department of Education,
“Pennsylvania’s school districts receive 57 percent of 
their revenues from local sources and 38 percent from 
the state. The state provides about 25 percent of
(local) general fund budget.”


This is one of the lowest rates in the United States,
 a disgraceful performance, placing Pennsylvania on a
 level with the poorest states in the union. If the 
state provided 50 percent or more of the operating 
budget of local schools, the school property taxes
 might be mitigated.

According to a recent study by the 
Pew Charitable Trusts, Pennsylvania placed 49th of the 
50 states in the state contribution to local school 
operating budgets.


Another misconception is that the federal government
 plays a major role in funding education. Not so. The 
federal government is a minor contributor to local
 school education funding.
 After all is said and done, state legislators are
 completely responsible for educating our children,
 even though the state has “loaned” much of that 
responsibility to local school boards.


Examine for yourselves their poor performance and ask yourselves why 
these people care so little about your child’s education.

How PMC's ER fixed serious problem

By William Doolittle
For the Messenger

The Pocono Medical Center's emergency room suffered serious problems in the past and a detailed study outlines the successful steps taken to cure
 them.

The study, published in Health Management Technology,
in April of 2006 said, PMC “struggled with high bed
 occupancy and surges in patient volume, six-hour wait 
times in the emergency department (ED), as well as 
other problems such as “lost” charts, poor
 documentation and low patient satisfaction.

The study of PMC’s situation noted “Also, it was hard 
to miss.. . . scores on patient satisfaction, which 
averaged 20 percent, reflecting that 80 percent of 
other hospitals did a better job pleasing ED 
patients.”

After the emergency room completed automating, the 
patient satisfaction scores reversed, with 80 percent 
patient approval.

Before it was automated, the emergency department
 treated 50,000 patients a year using mostly a paper
 tracking and registration system. Now, more than 70,000 patients
a year visit the ER.

The story points out that the situation was so
 serious that in 2001 hospital officials began to study
 an automated information system for the ER.

“For starters, triage or patient screening took at 
least an hour, which was too long, especially with 
chest pain patients. Long wait times not only put
 patients at risk, but also posed a public relations 
problem for the hospital,” the magazine reports.

“The hospital needed information from patients to get 
them registered and to track them, but this required a
lot of time and created the mistaken impression that 
the hospital was focused more on insurance information 
and medical record numbers than on patient care,” the 
study found.
“The Waiting Room Is Closed” was the name of the new
 policy of speeding patients through the admission 
process and into the ER itself for treatment.

The results were amazing.

Data from the system supplied baseline numbers of how 
to improve the operation, including:

  • Improved patient length of stay; more than 50 
percent of patients were in the ED more than four 
hours.
  • Eliminate lost charts; physicians estimated that 4
 percent were “lost” and no bill was issued.
  • Retain more nurses; they used an average of 23 
percent agency nurses because of staffing shortages.

The emergency department at PMC now handles more than
 70,000 visits a year, and although many patients may still disagree, it appears as if the ER has gone a long way toward solving its "satisfaction" problems.